From the National Heart, Lung, and Blood Institute's Framingham Heart Study, National Institutes of Health, Framingham, Massachusetts; Massachusetts General Hospital, Boston University School of Medicine, Beth Israel-Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts.

Grant Support: By contract N01-HC-38038 from the National Heart, Lung, and Blood Institute and grant AR/AG 41398 from the National Institutes of Health. Dr. Vasan was supported in part by a research career award 1K24 HL04334 from the National Heart, Lung, and Blood Institute.

In men, 99 cases of congestive heart failure occurred during 26 035 person-years of follow-up. In women, 120 cases of congestive heart failure occurred during 35 563 person-years of follow-up. After adjustment for multiple confounders, risk for congestive heart failure was lower among men at all levels of alcohol consumption compared with men who consumed less than 1 drink/wk. The hazard ratio for congestive heart failure was lowest among men who consumed 8 to 14 drinks/wk (0.41 [95% CI, 0.21 to 0.81]) compared with those who consumed less than 1 drink/wk. In women, the age-adjusted hazard ratio for congestive heart failure was lowest among those who consumed 3 to 7 drinks/wk (0.49 [CI, 0.25 to 0.96]) compared with those who consumed less than 1 drink/wk. However, after adjustment for multiple predictors of congestive heart failure, this association was no longer statistically significant.

Conclusions:

In the community, alcohol consumption is not associated with increased risk for congestive heart failure, even among heavy drinkers (≥ 15 drinks/wk in men and ≥ 8 drinks/wk in women). To the contrary, when consumed in moderation, alcohol appears to protect against congestive heart failure.